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Distribution of hepatitis C virus genotypes in Canada: Results from the LCDC Sentinel Health Unit Surveillance System
R Chaudhary1, M Tepper, S Eisaadany
1Laboratory for Viral Hepatitis, Bureau of Microbiology;
Insights
Hepatitis C virus (HCV) surveillance in Canada found injection drug use to be the primary risk factor for infection. Genotyping revealed HCV subtype 1a as the most common across Canada, though regional variations exist.
Area of Science:
- Hepatology
- Infectious Diseases
- Public Health Surveillance
Background:
- Hepatitis C virus (HCV) infection remains a significant global health concern.
- Understanding the epidemiology and prevalent strains of HCV is crucial for effective public health interventions.
Purpose of the Study:
- To conduct a sentinel hepatitis surveillance study in Canada to determine the prevalence of HCV infection.
- To identify major risk factors associated with HCV infection.
- To characterize the genotypic distribution of HCV isolates in Canada.
Main Methods:
- A sentinel surveillance study involving 1469 patients across sentinel health units.
- Serological testing for antibodies to HCV (anti-HCV).
- HCV RNA testing and genotyping of positive samples.
Main Results:
- A high prevalence of anti-HCV antibodies (65.3%) and HCV RNA (74.7% of tested samples) was observed.
- Injection drug use was identified as the predominant risk factor, reported in 71% of cases.
- HCV subtype 1a was the most prevalent genotype in Canada (48%), followed by subtype 3a (22%).
- Regional variations in subtype prevalence were noted, with subtype 3a being more common in Winnipeg and equally distributed with 1a in Guelph.
- Subtype 3a showed significantly higher prevalence among injection drug users compared to non-users.
Conclusions:
- Injection drug use is the primary driver of HCV infections in Canada.
- HCV subtype 1a is the predominant genotype circulating in Canada.
- Targeted prevention and treatment strategies focusing on injection drug users are essential for HCV control.
Abstract:
In a sentinel hepatitis surveillance study conducted by sentinel health units, 1469 patients were enrolled, and 959 (65.3%) were positive for antibody to hepatitis C virus (HCV). Samples from 387 patients (40.4%) were tested for HCV RNA, and 289 (74.7%) were positive for RNA. The major risk factor for HCV infection was injection drug use, reported in 71% of cases. The genotyping of HCV isolates showed that subtype 1a (48%) was predominant in Canada. The other subtypes detected were 1b (19%), 2a (6%), 2b (3%), 3a (22%) and 4a (1%). In Winnipeg, Manitoba, subtype 3a (47%) was more prevalent than subtype 1a (37%), and, in Guelph, Ontario, both subtypes 1a and 3a had equal (40%) distribution. The prevalence of subtype 3a was significantly higher in injection drug users (27%) than in nonusers (10%) (P<0.005). In Canada, injection drug use is the major risk factor for HCV infections, and subtype 1a is more prevalent.
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